D.C. Week: Obama Looks to Medicare for Savings

WASHINGTON -- As part of his plans to trim federal spending, President Obama called for more savings from Medicare in his State of the Union address this week, while Congress was busy with several healthcare investigations.

In the nearly hour-long speech, Obama also advocated doing away with a fee-for-service Medicare reimbursement system and replacing it with one that rewards quality.

"We'll bring down costs by changing the way our government pays for Medicare, because our medical bills shouldn't be based on the number of tests ordered or days spent in the hospital – they should be based on the quality of care that our seniors receive," he said.

Lawmakers looking to pull the trigger on finally doing away with the SGR, which is used to determine physician payments, must iron out many of the details that came to light during a hearing Thursday before the House Energy and Commerce Health Subcommittee.

But how to pay for doing away with the SGR, finding out how to measure and reward quality, and setting the time before those measures take effect are all unanswered questions. Lawmakers questioned Medicare Payment Advisory Commission Chair Glenn Hackbarth, JD, of Bend, Ore., and other experts for more than 3 hours Thursday on the SGR and payment reforms.

OIG: Drug REMS Falling Short

The FDA program that monitors drug safety risks is ineffective because drug manufacturers fail to comply with the program and the agency fails to enforce it, according to a government report.

In addition, the inspector general's office said that "nearly half of sponsor assessments for the 49 REMS we reviewed did not include all information requested in FDA assessment plans, and 10 were not submitted to FDA within required time frames."

On Thursday, all 17 members of the agency's Medical Imaging Drugs Advisory Committee recommended approving a novel gadolinium-based MRI contrast agent (Dotarem) in adults and children older than 2, but not for younger children.

Congress Probes Mental Services at the VA

Mental health services at the Department of Veterans Affairs (VA) don't seem to be improving despite increases of nearly 40% in both staff and budget in the last 6 years, a congressional committee charged Wednesday.

Veterans still wait on average 50 days for an evaluation through the VA and the suicide rate for veterans increased for the third time in 4 years in 2012, members of the House Veterans' Affairs Committee said. Suicides have surpassed the number of combat deaths.

"While I am and will remain supportive of the improvements the department is attempting to undertake internally, it has become painfully clear to me that VA is focused more on its process and not its outcomes," Chairman Jeff Miller (R-Fla.) said during a hearing on the department's efforts in mental healthcare.

Senators Investigate Rx Drug Abuse

Three senators including Sen. Jay Rockefeller (D-W. Va.), who is set to retire at the end of 2014, are asking three federal agencies to investigators efforts on prescription drug abuse.

Republican leaders of the House Energy and Commerce Committee wrote Health and Human Services Secretary Kathleen Sebelius asking how Health Insurance Portability and Accountability Act (HIPAA) limits state and local governments from sharing mental health records with the National Instant Criminal Background Check System (NICS).

The request is part of an investigation by Oversight and Investigations Subcommittee Chairman Tim Murphy, PhD (R-Pa.), a clinical psychologist, into the causes of mass violence.

"According to several news reports and a recent Government Accountability Office Report, several states as well as the District of Columbia do not provide mental health records to NICS over concerns that providing such records violates the HIPAA Privacy Rule," the lawmakers wrote to Sebelius on Thursday.

Health Fraud Recoveries Reach Record Levels

Investigators recovered a record $4.2 billion in fraud of federal health programs for fiscal 2012, HHS announced Monday, up from nearly $4.1 billion in fiscal 2011.

The Obama administration has recovered $14.9 billion in the last four years, up from the $6.7 billion from the prior 4-year period, HHS said.

The department added they have recovered $7.90 for every dollar spent on healthcare-related fraud and abuse efforts in the last 3 years.

Next Week

Congress is off next week for the Presidents' Day holiday.

The American College of Physicians will release its annual "State of the U.S. Health Care System" report on Wednesday.

Also on Wednesday, the Institute of Medicine will release its assessment of the President's Emergency Plan for AIDS Relief, as requested by Congress.

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